Diabetes and Dieting

[888mom]

How do diabetics lose weight?  Is it slower than normal people?  I also have an autoimmune disease (mixed connective tissue disorder).  I was normal weight a little over 2 years ago before getting pregnant and got gestational diabetes and gained 90 pounds while pregnant.  That turned in to type II diabetes after I delivered, and I feel like I'm stuck at too high of a weight right now (just over 200 pounds at 5'5").  I have taken a little off since being on metformin, about 5 pounds in 6 weeks.  Is it just going to take a while?  Can my doctor recommend a weight loss medication since I have diabetes?  She was reluctant to even talk about it with me and said I needed to focus on getting healthy instead of getting thinner right now, and focus on getting my autoimmune disease a little more under control.  But, isn't staying fat not healthy either?  My blood sugar levels are controlled well with metformin and low carb dieting.  How low carb can I go?  I am eating about 12 carb choices per day, with a caloric intake of around 1400 calories, with high fiber.  It is hard to exercise in winter and I can't afford a gym membership with all my medication copays, plus I have a 2 year old with autism who has therapy 4 times per week plus it is just tired mommying.  Is exercise essential for diabetics, or can you lose weight without the exercise?  Is stress bad for diabetics?  I notice when I get really really stressed, my blood sugar levels go higher quite a bit, even if I've eaten not many carbs.  I realize there are a lot of questions I have.  I just have not been able to ask my doctor everything because I  had so many other questions for her to answer and there's only a certain amount of time they have to see you during the visit.  Right now I am not seeing an endocrinologist for my diabetes, just my primary care physician and my rhumatologist.

[Anita Ramsetty, MD]

HI,
I agree that weight loss will take some time(doing it safely, that is). You have done a great job already, and you seem to be following a good diet plan right now. Keep your chin up! It will happen, but it does take work.

Exercise as much as you can. Walking is great, so even if you cannot get to a gym a brisk walk for about 30-50 minutes atleast 4 times a week will help tremendously.  

I know this will cost but it may be worth it: many of my friends and patients have had great success with formal programs like Weight Watchers, so if it is an option I would encourage you to look into those.

There are diet medications that are approved for use, but they have potential side effects that need to be considered(and still need you to follow diet plans etc). Ask you doctor about Meridia and Orlistat. Alli is now in stores and over the counter, so you can check into that as well.

And definitely, stress does make things worse. It is tough with a little one regardless, and your situation has some additional challenges. Breathe, and try as best you can. erelax when the opportunity, no matter how rare, comes your way.
Good luck and take care. You are doing great.

[granmammy]

God love you!  Yes, we do lose weight slower, but 5lbs in 6 weeks is terrific!  You don't want to dump weight because then you'll be falling into low blood sugars which have a much more immediate, dangerous effect.  Based on what my dietician told me, your on the low end of the calorie spectrum for your diet, so you're already doing the most you can.  Exercise is essential to diabetic control.  While they now recommend 1 hour of aerobic exercise a day (walking), I have found that whatever it is, I'm better off doing something I know I will stick with rather than burning out on a routine that can't be held up come a change in weather or whatever.

Stress definitely plays havoc with blood sugars.  I'd say raising a two-year-old autistic child counts as stress.  Having an autoimmune disease can't be any picnic either.  If you have a man in your life you doesn't like you fat, tell him to watch the baby for an hour while you go for a walk.  It will help relieve your stress level too!  If you're on your own, just do what you can.  If you ever have someone offer to help you if you need it, tell them they can watch the baby for one hour.  You go for the walk, relieve your stress, get your heart rate going and burn those carbs.

I'd say give yourself a break and follow your doctor's advice, concentrate on getting well.  Be patient with the weight loss, it will come.  You have enough to deal with.